Despite investments made to broadly enhance mental health support for Australians, a stronger focus on the psychology workforce and psychological services is required.
The Australian Psychological Society (APS) has criticised this week’s Budget saying much more investment is needed to overcome the challenges facing the community and the psychology sector. “The community wants more investment in psychology services right now, and this week's Budget falls short of that,” says APS President Dr Catriona Davis-McCabe.
Recent research conducted by the APS found that levels of mental health challenges are growing in our community, particularly for younger Australians. Rates of psychological distress in 15-24 year-olds increased from 18.4% in 2011 to 42.3% in 2021.
"This is a point in our nation's history when we need to double down on psychological support and investment in order to create a mentally resilient community," she says. "This is especially true of our young people, who are carrying the burden of emotionally complex situations, such as global conflicts, increasing acts of violence in our communities and the far-reaching impacts of climate change."
APS will continue to advocate for a 'youth safety net' to Medicare, which aims to remove out-of-pocket costs for 14-24 year-olds seeking mental health support. (You can read more about that here).
"We'll also continue conversations about reaching a 1:500 psychologist-to-student ratio in all Australian primary and secondary schools, as mental health support is paramount during this crucial developmental period in their lives."
APS research shows us that the majority (68%) of Australians trust psychologists and see them as providing an essential service to our community.
"This proves that further investment into the sector – including reinstating the 20 Medicare-subsided sessions – would make a huge impact. We feel that with this Budget, the government has missed opportunities to enhance the mental wellbeing of all Australians."
Cost barriers continue
The APS Thinking Futures report (February 2024) of 2068 community members found that 95% of Australians see immediate government investment in psychology services as important, and that 73% agree that investing in psychology would reduce overall costs to the health system and economy.
Following this week's Budget, it seems cost will continue to be a barrier for many Australians. Since the Better Access review was released, there has been a 40% increase in the most disadvantaged Australians citing cost as the reason they delayed or did not see a psychologist in 2022-23, according to the latest Australian Bureau of Statistics (ABS) Patients Experience Survey.
Our own research backs this up, showing that 75 per cent of Australians report cost as one of their biggest barriers to accessing psychology services.
"Every Australian deserves access to psychologists when and where they need it. Our community shouldn't have to forgo this critical mental health support due to factors such as where they live and how much money they make," says Davis-McCabe.
During a cost-of-living crisis it is extremely disappointing patients will continue to face an average gap fee of $100. Too many people are using their credit card instead of a Medicare card to pay for their psychology treatment,” she says.
However, she says the significant cost-of-living relief package announced, including a $3.5 billion energy relief bill and the re-introduction of stage 3 tax cuts, will go some way in alleviating mental health issues, as this was identified as a driver of mental ill-health in APS's research.
Digital mental health support and Medicare
Another Federal Budget announcement was the $588.5 million investment into a free "low-intensity" digital service for people at risk of or experiencing mild mental health illness.
"This service could act as a triage system for those who previously cited cost as a barrier to receiving comprehensive mental health support, but this is targeted at those with mild conditions.
“We also need to consider those with complex mental health conditions – these are the vulnerable Australians we need to protect."
The Government announced it will upgrade the clinical capacity of walk-in adult mental health centres, to improve access to psychologists and psychiatrists.
"These centres will provide new employment opportunities for psychologists in the public sector, alongside psychiatrists. We’re really pleased the expertise and impact of psychologists has been acknowledged in this way, and we will advocate for these public sector positions to have adequate professional development and supervision, including appropriate career pathways and remuneration."
While APS broadly supports the enhancement of the Medicare Mental Health Centres, the $29 million allocated towards this initiative is unlikely to be enough to deliver this service in a meaningful way.
“We want to see improved access for people who need it, but to do this you need meaningful investment from government.
APS saw the government's lack of commitment to re-introducing 20 Medicare session policy as another oversight in this year’s Budget.
While we are not surprised, and despite our firm focus on this as an advocacy priority for APS members, we are profoundly disappointed the government has not yet committed to re-introducing the 20 Medicare-rebated sessions.
"The government’s position is that clinicians and patients need a more sophisticated offering than additional psychology sessions. We strongly disagree with this and will continue to advocate for more than 10 sessions.
“Patients with, or at risk of, developing complex mental health issues should at least have access to 20 Medicare-rebated sessions within Better Access, if not more."
There's no substitute for psychologists
Another element of interest in the Budget is the announcement government will explore the introduction of a ‘psychology assistant’ role to the broader mental health workforce.
The APS welcomes discussions about ways to extend the mental health workforce and enhance the community’s access to care, but is approaching this announcement with caution.
"There is no substitute for professionally trained and registered psychologists.
“We spend 6+ years training, and we are dealing with the most complex aspects of the human condition. That requires years of research, learning and practical experience."
“Our well established and evidence-based position is that we need more psychologists in Australia, and we will continue advocating for more investment to address the psychology workforce shortfall,” she said.
Davis-McCabe said the APS wants to see investment in some key initiatives that will expand the workforce and ultimately make access to psychological services easier for people who need it.
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Investing in more psychology postgraduate university places
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Investment to support overseas trained psychologists to join the Australian workforce.
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Paid placements for psychology under the newly announced Commonwealth Prac Payment.
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Replicating GP regional relocation incentives for psychologists to make psychology services more accessible in rural and remote areas.
"Multiple reports show that the Federal Government is meeting just 35 per cent of its own workforce target for psychology. Our country is in the grips of a mental health crisis and yet, the Budget fails to address the shortfall," says Davis-McCabe.
“Australians expect to see the government invest in expanding our workforce and they want to see it happen now."